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Conference Paper: A case-control study of frequent nightmares in patients with major depressive disorder (MDD)

TitleA case-control study of frequent nightmares in patients with major depressive disorder (MDD)
Authors
Issue Date2017
PublisherOxford University Press. The Journal's web site is located at http://www.journalsleep.org
Citation
The 31st Annual Meeting of the Associated Professional Sleep Societies (SLEEP 2017), Boston, MA, USA, 3-7 June 2017. In Sleep, 2017, v. 40 n. Suppl. 1, p. A408, abstract no. 1095 How to Cite?
AbstractIntroduction: Nightmare disturbance is a common yet often neglected sleep complaint in patients with major depressive disorder (MDD). The aims of the present study were to establish the clinical, psychosocial, and polysomnographic profiles of the depressed patients with frequent nightmares through a case-control study. Methods: Three groups of participants were recruited from the psychiatric outpatient clinic of a regional hospital and the local community in Hong Kong: 1) depressed patients with an active complaint of frequent nightmares, which were defined as having nightmares at least once per week as confirmed by both the retrospective questionnaire assessment and prospective daily mood and dream diary (n=35), 2) age- and gender-matched depressed patients without frequent nightmares (n=35), 3) age- and gender-matched healthy normal controls (n=35). All recruited depressed patients had no comorbid posttraumatic stress disorder (PTSD). Comprehensive in-depth assessments were conducted, including a clinical interview by Mini International Neuropsychiatric Interview (MINI), a battery of questionnaires (Beck Depression Inventory, BDI; Hospital Anxiety and Depression Scale, HADS; Insomnia Severity Index, ISI; Revised-Impact of Event Scale, R-IES; and Beck’s Scale for Suicidal Ideation, BSSI), and one overnight polysomnographic and 7-day of actigraphic sleep assessments. Results: Depressed patients with frequent nightmares were more likely to show melancholic features (p<.05), more severe insomnia symptoms (p<.001), increased anxiety (p<.001) and depressive symptoms (p<.001) as well as a heightened level of suicidal risk (p<.001). They also scored significantly higher on R-IES intrusion (p<.001), avoidance (p<.001), and hyperarousal (p<.001). In addition, depressed patients with frequent nightmares exhibited higher REM density (p<.05), longer REM latency (p<.05) and less REM sleep periods (p<.05) as compared to healthy controls. Whilst there were no significant differences in average sleep parameters as measured by actigraphy, depressed patients with frequent nightmares showed a greater night-to-night variability in wake-after-sleep onset (p<.01), % of wake time (p<.01), % of mobile time (p<.01) and fragmentation index (p<.05). Conclusion: Frequent nightmares represent a distressing sleep problem associated with a more severe clinical presentation and increased suicidality in patients with MDD. Enhanced clinical attention and targeted sleep treatment should be directed to address nightmare complaint in depressed patients.
DescriptionThe Meeting was organized by Sleep Research Society and American Academy of Sleep Medicine
Persistent Identifierhttp://hdl.handle.net/10722/245767
ISSN
2015 Impact Factor: 4.793
2015 SCImago Journal Rankings: 2.606
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, XS-
dc.contributor.authorLam, SP-
dc.contributor.authorZhang, J-
dc.contributor.authorYu, MWM-
dc.contributor.authorChan, JWY-
dc.contributor.authorChan, NY-
dc.contributor.authorWing, YK-
dc.date.accessioned2017-09-18T02:16:30Z-
dc.date.available2017-09-18T02:16:30Z-
dc.date.issued2017-
dc.identifier.citationThe 31st Annual Meeting of the Associated Professional Sleep Societies (SLEEP 2017), Boston, MA, USA, 3-7 June 2017. In Sleep, 2017, v. 40 n. Suppl. 1, p. A408, abstract no. 1095-
dc.identifier.issn0161-8105-
dc.identifier.urihttp://hdl.handle.net/10722/245767-
dc.descriptionThe Meeting was organized by Sleep Research Society and American Academy of Sleep Medicine-
dc.description.abstractIntroduction: Nightmare disturbance is a common yet often neglected sleep complaint in patients with major depressive disorder (MDD). The aims of the present study were to establish the clinical, psychosocial, and polysomnographic profiles of the depressed patients with frequent nightmares through a case-control study. Methods: Three groups of participants were recruited from the psychiatric outpatient clinic of a regional hospital and the local community in Hong Kong: 1) depressed patients with an active complaint of frequent nightmares, which were defined as having nightmares at least once per week as confirmed by both the retrospective questionnaire assessment and prospective daily mood and dream diary (n=35), 2) age- and gender-matched depressed patients without frequent nightmares (n=35), 3) age- and gender-matched healthy normal controls (n=35). All recruited depressed patients had no comorbid posttraumatic stress disorder (PTSD). Comprehensive in-depth assessments were conducted, including a clinical interview by Mini International Neuropsychiatric Interview (MINI), a battery of questionnaires (Beck Depression Inventory, BDI; Hospital Anxiety and Depression Scale, HADS; Insomnia Severity Index, ISI; Revised-Impact of Event Scale, R-IES; and Beck’s Scale for Suicidal Ideation, BSSI), and one overnight polysomnographic and 7-day of actigraphic sleep assessments. Results: Depressed patients with frequent nightmares were more likely to show melancholic features (p<.05), more severe insomnia symptoms (p<.001), increased anxiety (p<.001) and depressive symptoms (p<.001) as well as a heightened level of suicidal risk (p<.001). They also scored significantly higher on R-IES intrusion (p<.001), avoidance (p<.001), and hyperarousal (p<.001). In addition, depressed patients with frequent nightmares exhibited higher REM density (p<.05), longer REM latency (p<.05) and less REM sleep periods (p<.05) as compared to healthy controls. Whilst there were no significant differences in average sleep parameters as measured by actigraphy, depressed patients with frequent nightmares showed a greater night-to-night variability in wake-after-sleep onset (p<.01), % of wake time (p<.01), % of mobile time (p<.01) and fragmentation index (p<.05). Conclusion: Frequent nightmares represent a distressing sleep problem associated with a more severe clinical presentation and increased suicidality in patients with MDD. Enhanced clinical attention and targeted sleep treatment should be directed to address nightmare complaint in depressed patients.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://www.journalsleep.org-
dc.relation.ispartofSleep-
dc.titleA case-control study of frequent nightmares in patients with major depressive disorder (MDD)-
dc.typeConference_Paper-
dc.identifier.emailLi, XS: shirleyx@hku.hk-
dc.identifier.authorityLi, XS=rp02114-
dc.identifier.doi10.1093/sleepj/zsx050.1094-
dc.identifier.hkuros278458-
dc.identifier.volume40-
dc.identifier.issueSuppl. 1-
dc.identifier.spageA408-
dc.identifier.epageA408-
dc.identifier.isiWOS:000433175001314-
dc.publisher.placeUnited States-

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